Speaking of Health; Furunculosis (Boils)

By Gilda Morales, ANP, DC

Today’s column will address a common skin disorder that most people will encounter during their lifetimes—boils, or using the medical term for it, furunculosis.  Boils are usually the result of a bacterial abscess of a hair follicle, with the most likely culprit being Staphylococcus aureus, Staph for short.

Boils are more predominant in male teenagers and young adults, in crowded living quarters, in families and in locker rooms.  The infection begins at the base of the hair follicle and spreads to the surrounding skin.  There are certain risk factors that predispose patients to this infection, which is naturally carried in the nose, skin, underarms and in the perineum.  Patients with diabetes, alcoholics, who are obese, and are malnourished are more at risk, as well as those who are immunocompromised.  Those with a positive family history and even those patients who take medications that can impair production of the cells responsible for fighting infections, such as omeprazole, are also more at risk.

Most boils are found at hairy areas that are susceptible to frequent friction such as the belt area, front of thighs, the nape of the neck and the buttocks.  The infected follicle will usually enlarge, become painful and eventually develop into an abscess, which will usually drain on its own.

Treatment for boils consists of using moist, warm, compresses, at least four times daily, for 30 minutes at a time.  If the boil is large and has a head or is pointing, it should be incised and drained.  If the patient has a compromised immune system, the patient should have a culture performed to check for MRSA, or methicillin-resistant-staph-aureus bacteria.

The patient should also practice fastidious hygiene, change towels, washcloths and sheets daily, clean shavers, not share items of personal hygiene, and avoid picking the nose.  In most cases, antibiotics are not necessary unless there are multiple boils or there is extensive inflammation, redness and obvious infection.  In recurrent cases, the patient should wash his/her entire body and fingernails with a nailbrush daily with Betadine, pHisoHex soap, or Hibiclens.  Occasionally, the patient will be advised to use a topical antibiotic in the nose daily.